Topical photodynamic therapy with 5-aminolevulinic acid in Chinese patients with Rosacea

Background: Rosacea is difficult to cure and frequently recurs. Topical photodynamic therapy (PDT) has been tentatively used, with only preliminary results reported. Objective: To evaluate the efficacy and safety of topical PDT in Chinese patients with rosacea. Methods & Materials: Seventeen participants with rosacea were treated three times using 5-aminolevulinic acid (ALA)-PDT at intervals of 7-10 days. Papule and pustule numbers, erythema severity, telangiectasia severity, physician's global assessment (PGA) score (1 [best]-6), and patient satisfaction score (0-3 [highest]) were assessed. Rosacea improvement and the total effective rate were calculated. Stratum corneum hydration and sebum levels, and the melanin index (MI) and erythema index (EI) were measured non-invasively. Results: After three treatments with ALA-PDT, the total effective rate (≥50% improvement) was 64.71%, mean PGA score was 2.88 ± 0.93, and mean patient satisfaction score was 1.71 ± 0.69. The EI significantly decreased 1 month after the final treatment (from 468 ± 80.61 to 439 ± 77.78 for the forehead and from 507.65 ± 92.51 to 483.27 ± 78.32 for the nasal ala). Four participants received three additional treatments. They achieved 50-74% improvement after three treatments and ≥75% improvement after six treatments. Conclusion: ALA-PDT is safe and effective for treating rosacea.